Background: The purpose of this review is to provide a structured overview of emerging diagnostic and therapeutic modalities for delirium in critically ill patients. Methods: Literature searches were carried out to identify relevant articles for both diagnostic and therapeutic approaches other than those included in the 2018 Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU guidelines, including prospective and retrospective studies. Results: Regarding diagnostic approaches seven articles were included. The Neelon and Champagne (NEECHAM) Confusion Scale, Stanford Proxy Test for Delirium (S-PTD), and DelApp- ICU yielded excellent diagnostic performances. We included seven articles studying different therapies. Some therapies showed potential to decrease the burden of delirium, using different pathophysiological pathways than antipsychotics. Conclusion: Alternative screening tools may help in ICU delirium detection, either as replacement or combined with the Confusion Assessment Method for ICU (CAM-ICU) and Intensive Care Delirium Screening Checklist (ICDSC), and other therapies than antipsychotics may reduce delirium burden, but further studies are required.

Critical care, Critical care outcomes, Critical illness, Delirium, Diagnosis, Intensive care unit, Therapeutics
Netherlands Journal of Critical Care
Department of Intensive Care

Smit, L. (L.), & van der Jagt, M. (2020). Delirium in the ICU – a structured review of promising diagnostic and therapeutic approaches: Next steps in ICU delirium. Netherlands Journal of Critical Care (Vol. 28, pp. 126–133). Retrieved from